DOH Finalizes Supplemental PACE Rates
The Department of Health (DOH) has distributed updated (supplemental) April 2023 Medicaid rates to Programs of All-Inclusive Care for the Elderly (PACE). The rates have been approved by the Division of the Budget (DOB) and the Centers for Medicare and Medicaid Services (CMS) and are considered final. Programs should see payment of the updated rates retroactive to April 1, 2023 in Medicaid cycle 2421, scheduled for release on Jan. 31st.
Because PACE rates are based on the costs that would have been incurred to provide services to individuals had PACE not been available, the updated rates reflect updates recently made to partially capitated Managed Long Term Care (MLTC) plan rates as well as to mainstream managed care premiums and Medicaid fee-for-service rates for services in the PACE benefit package. Along with increases to the home care minimum wage, the updates reflect increases made in 2023 to hospital and nursing home rates, the behavioral health minimum fee schedule, and several other changes such as the policy changes related to reimbursement for primary care services and allowing expanded telehealth billing by Medicaid providers.
The changes are detailed in an updated Information Sharing Report that should have accompanied the rate sheets. DOH is scheduling a meeting to discuss the updated rates and should be sending a meeting invitation shortly.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841